Decision on meaningful use due this week

Decision on meaningful use due this week

Summary: On June 16 David Blumenthal, the President's National Coordinator of Health IT, will call the second meeting of its Advisers Committee together, and try to get them on board with his definition of "meaningful use," which systems must meet to be eligible for $19 billion in HITECH funding.

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Tomorrow, health reform either lives or dies.

On June 16 David Blumenthal, the President's National Coordinator of Health IT, will call the second meeting of its Advisers Committee together, and try to get them on board with his definition of "meaningful use," which systems must meet to be eligible for $19 billion in HITECH funding.

I wrote last month that a compromise is expected between the idea of industry controlling the funds through its CCHIT certification group, and a simpler criteria under which Electronic Medical Record (EMR) systems can be built using modular parts.

Since then reformers like Brian KlepperScott Silvertein have grown despondent. Quoting a Washington Post story about the efforts of CCHIT and HIMSS, the industry group which created it, to control certification, he wrote last week:

Now those funds will probably favor outdated, non-interoperable, client-server technologies from a small number of legacy IT companies. Newer, more effective, less costly web-based tools from hundreds of innovative firms will likely have to base their success on market appeal, without the government's help. 

Klepper Silverstein was especially exercised about an effort in New Jersey to require CCHIT certification on all new health IT gear in that state, not just gear eligible for HITECH funding.

CCHIT head Mark Leavitt responded to Klepper's trhe post, and Klepper, who writes at the Health Care Renewal blog under the pen name MedInformatics MD, incorporated it in his post. Leavitt's e-mail denied his group was behind the effort to control certification on behalf of incumbents, then claimed Klepper'sSilvertein's ire is due to his failure to be hired by vendor NextGen in 2004.

What that reads like to me is a non-denial denial. We'd never lobby to control health IT, but you're just a disgruntled office seeker and so have no standing. I suppose he'd call me just a general assignment reporter with no special expertise (guilty), perhaps just an angry blogger (sometimes I am).

But the result of Leavitt's dismissal is to write-out all criticism of industry efforts to keep health IT mired in 1970s thinking, approving only the use of systems rather than modules, and rejecting all computing progress since, such as open source, open standards and plug and play.

Anyone with in-depth knowledge will have been involved with vendors at one point, and anyone else can be dismissed as a crank.

Leavitt will be holding a town call with vendors tomorrow afternoon to "focus on concerns regarding certification of applications licensed under open-source models," writes Health Imaging, and a second call the following day to sell the industry's position to the public.

My hope is that the second call will be an all-on attack on Blumenthal, because he has to show his hand on meaningful use tomorrow, and if that definition makes Leavitt happy it's bound to make reformers unhappy.

Topics: IT Employment, CXO, Enterprise Software, Health

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3 comments
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  • Incorrect citation

    Dana, the Healthcare Renewal posts you linked were mine ("an effort
    in New Jersey to require CCHIT certification" and "failure to be hired
    by vendor NextGen in 2004").

    Klepper did write the post at
    http://www.thehealthcareblog.com/the_health_care_blog
    /2009/06/the-health-industrys-achilles-heel.html .

    Also note I wasn't "incensed" by my failure to be called back by this
    company after the initial call. That's their right. In that several-
    months-old post and others at Healthcare Renewal I was pointing out
    that the vendor leaders can be patronizing and irritating, and have (for
    at least since I started in medical informatics in 1992) not optimally
    leveraged a pool of medical informatics talent to their own detriment.
    It's sad to watch, as patients end up suffering.

    And the vendor execs sometimes also exaggerate their credentials as I
    wrote. When I see a HIT exec claiming a mysterious "American
    Medical Informatics Certification for Health Information Technology"
    while medical professionals dedicate several years of our lives to gain
    medical informatics expertise through graduate or post graduate
    training, it's quite disappointing.

    Use of my months old Nextgen-related post to insinuate
    "disgruntlement" is a time-honored technique of ad hominem. It's
    usually done to discredit a person's arguments, but in this case all I
    did was ask questions as shown. So I am unsure of the purpose of the
    links to that old post in CCHIT's reply to my questions about the
    provenance of the NJ Bill. "Snarling but unrugged individualism"
    might be an apt description of the technique.

    Scot
    MedInformaticsMD
    scotsilv
    • My apologies. Absolutely right on all counts

      I have changed the post to reflect the facts. I
      got you and Brian confused somehow and didn't
      double-check as I should.
      DanaBlankenhorn
      • Re: My apologies. Absolutely right on all counts

        It happens to busy people, me included. Of importance, you got the
        issues correct.
        scotsilv